HomeMy WebLinkAbout0014 WHIP-O-WILL DRIVE - Health (2) �.�� l �+
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SOIL EVALUATOR& PERCOLATION TEST FORMS
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oFtHEip� Town of Barnstable
I BARNSTABLE, ` Dcpartinent of 1-Icalth, Safety, and rnvironmcntal Services
9 MASS.
wp i63q• 6. Public Health Division
iED MAC
367 Main Street, Hyannis MA 02601
(NI icc: 509-790-6265
VA X: 508-775-3344
' ' II�Z�)111 ASSeSSIIl ell t 16T S e wag Dls os�i1
Solt Su y
ASSESSORS MAP NO`
PARCEL NO•
p ' Sr / 6 �l�.Ls
NO. Date:C� ��g
/1/7 -
� Uate'
Pcrlormed By: 'ter� '� �y -----
Witnessed By:
b �a/2a — Otu�l o O a2�/STQBG�
owner's Name
I.ocallonAddress � L M • �2`>S�J�18 �
Address.and AA
Iola: -5 C�'Z�SZ
/ ! Telephone a
Assessor's map/Parcel: ( �(p
NEW CONS'IRt1C'I-ION ✓ REPAIR
Office Review /
Published Soil Survey Available: No Yes ✓ it
Year Published _ Publication Scale :1 APU Soil map unit
Drainage Class E,(4 Cf E_ Soil Limitations
Yes
Surficial Geological Report Available: No Y e
Year Published _ l9? Publication Scale —
Geologic Material(Map Unit)
Landform vvrw,asAl e-A�Al
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes
Wetland Area: _
National Wetland Inventory Map(map unit)
Wetlands Conservancy Program Map(map unit) 44 K --
Current Water Resource Conditions(U GS): Month
Normal
Range: Above Normal k0,'✓ Normal
Other References Reviewed: U iyj ---U
DEP APPROVED DORM- 12/07/95
FORM 11 - S011. p,N'ALUA,rolt Fpage ��1,
Location Address or Lot lJo. Jf
Oia-site Review
e
Al,q/' 7
/9V6 Time: /o Weather Cc.c•4/1 SD
Deep Hole Number Date:
Location (identity on site plan) o Surface Stones
/v�TI�O—'Otto
Slope ( /o) O'3 ,
Land Use ,�i:S �.p p,[,
Vegetation WODDBD
Landform 0druAS14
Position on landscape (sketch on the back)
Distances from: — feet
feet Drainage waY
Open Water Body /000 feet Property Line /D feet
Possible Wet Area 20o feet
Other
Drinking Water Well
DEEP
OBSERVATION HOLE LOG
Other
Soil Color Soil
(Structure,Stones, Boulders, Consistency, °�
Soil Horizon Soil Texture (Munsell) Mottling Gravel)
Depth from (USDA)
Surface (Inches)
O ArAM
/o=ZZ co w ce►•M.r ss.&1r, Coen�
LoQd S
n
DepthtoBedrock:
Parent Material(geologic Weeping from Pit Face:
De th to Groundwater: Standing Water in the Hole:
7_.rr. G' � 3►� .
Estimated Seasonal High Ground Water: ���^'v
DEP APPROVED F0101•12/07/95
FORM 11 - SOIL, 1;VALLIA'TOIt F010
Page 3 or
Location Address or Lot No. S D
D
etermination for Seasonal Hi li Water Table
Method Used:
t_7 Depth observed standing in observation hole F7~ inches
❑ Depth weeping from side of observation hole
inches
❑ Depth to soil mottles inches
El Ground water adjustment
feet ' ,
Index Well Number ... '"IW IJ Reading Date Index well level B•8
Adjustment factor .4"1 Adjusted ground water level
,Q�cttcva Wd� ,�?/,aic.�e�
abi.9s
�
De th of Natural) Oc ;urring Pervious Material
Does at least four feet a naturally sed for the soil absorption ervious rial exist system?in all area
observed throughout the area proposed —t--
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that_on M 9 /49 (date) I have passed the soil evaluator examinatio
si
approved by the Department of t with the reqal uired u redtection training,expertise ano experied that the above ana nc
was performed by me consistent q
described in 310 CMR 15.017. Date Ald/
YJ Da 7. 19gG
Signature .
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DEP APPROVED FORM• 12/07/95
FORM 12 - PERCOLATION TEST
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Location Address or Lot No. 5 ��lil� " �-
COMMONWEALTH OF MASSACHUSETTS
,ds7-,*6445; , Massachusetts
Percolation Test*
Date: Aldd. 7 Time% e)
Observation Hole # 2
Depth of Perc
Start Pre-soak
End Pre-soak
Time at 12"
Time at 9"
Time at 6"
Time (9"_6")
vvaBcsr Si4 v
Rate Min./Inch to/1550ME �i1412 "/A'/
Minimum of i percolation test must be performed in both the primary area AND
reserve area.
Site Passed LJ Site Failed ❑
.......................................................................................
Performed By:
Witnessed By: w
Comments: o v..+J�� 5.:.�7" .. : . .........,. ...,....: :.. .... .:. ......__..1�....... ......__..
4,9wdDtvar15YZ--, .
DEP APPROVED FORM-12/07/95